Breast cancer is a malignant tumor – a tumor with the potential to invade other tissues or spread to other parts of the body. It starts in the cells of the breast and can occur both in men and women, however is rare in males. Breast cancer is the most common cancer in women in India and accounts for 14% of all cancers in women. Overall, 1 in 28 women is likely to develop breast cancer during her lifetime. The incidence is high in urban areas, with 1 in 22 women is likely to develop breast cancer during her lifetime as compared to rural areas where 1 in 60 women develops breast cancer in her lifetime. The incidence has been on the rise over the past few years, as against 1,15,251 detected in 2008, 1,62,468 cases were found in 2018.
Breast Cancer has two types of risk factors. The non-modifiable risk factors are Age, Gender, Genetic Factors and Family history of cancer. Risk factors which can be modified with life style changes are Obesity, Pregnancy, Lactation and avoiding alcohol consumption. However, having a risk factor is no indication of one definitely developing breast cancer.
The life style modifications that can be adopted to prevent breast cancer are regular exercise, maintaining ideal body weight, quitting smoking, avoiding excessive alcohol consumption and breast-feeding.
Early detection is critical in treating breast cancer and can be identified by performing
- Breast self-examination (BSE) from the age of 30 years, every month immediately a week after the menses stops.
- Clinical breast examination (CBE) once in a year or 3 years by an oncologist / physician.
- Screening with a mammogram from the age of 40 years.
Treating early stage disease will improve chances of recovery significantly, in Stage 1 with up to 2 cm tumor, the survival is 100%, however in Stage 4 with the disease spreading to other organs, the survival scope is 22%.
The Signs and Symptoms of Breast Cancer are
- The most common symptom of breast cancer is a lump in the breast.
- Any change in the breast or nipple appearance.
- Unexplained change in shape or size of the breast – shrinkage or swelling of the breast, especially on one side.
- Recent unevenness of the breasts. It is normal for women to have one breast slightly smaller than the other, but if this asymmetry is a recent one, then one should consult a doctor.
- Dimpling on the breast.
- Retracted nipple.
- Orange peel like changes on skin of the breast.
- Boody nipple discharge.
- Swelling in armpits.
In case of a lump being present, the diagnosis of cancer involves
- Imaging Tests
- Ultrasound for younger women less than 30 years
- Mammogram for woman aged more than 30 years
- Biopsy provides an accurate diagnosis, it confirms if the lump is cancer or not.
The surgical options to treat breast cancer are
- Mastectomy, which involves removal whole of Breast tissue that is affected.
- Breast conservation surgery, involveseither removal of small amount of breast tissue called quadrantectomy or partial mastectomy, which includes wide local excision of cancer along with surrounding tissue. Breast conserving surgery is a boon to the woman suffering from breast cancer. As most of the breast conserving surgeries are day care procedures, this saves a lot of time in terms of post operative care and reduces the treatment cost. The woman can return home early to be with her loved ones and go back to her normal routine, that boasts her self esteem and reduces depression.
- Sentinel lymph node biopsyprocedure involves removal of only the primary draining lymph nodes present in the arm pit in select cases, without removing whole of the nodes, thus reducing the post operative pain and swelling of arm, post-surgery.
- Breast reconstructionis an advanced procedure where breast implants (silicone / water gel) is usually placed behind the muscle of chest. Prepectoral implants represent a new and less painful procedure which enables quick recovery of the patients. Moreover the entire surgery can be done through a small incision making the procedure less invasive.
- Onco plastic reconstructionis a natural alternative by using patients own tissues (skin, fat, and muscle) to replace the breast tissue lost following surgery. Therefore it gives a natural feel and look to the patient without uncomfortable sensation of foreign body or implant.
The treatment of cancer and the recovery rate is overall satisfactory with early detection of cancers, particularly due to advances in surgery, chemotherapy and radiotherapy. It is important to maintain positive attitude and an active physical lifestyle for better treatment outcomes. Being positive and exercising daily releases endorphins, which are chemicals released by the body that reduce the perception of pain and also triggers a positive feeling. This makes the person more relaxed and happy. In addition strong family support system plays a critical role for the overall health and recovery of the patient. These significantly enhance the efficacy of advanced and modern treatment.
